Ask Karen

no home will take him

Posted: 6/10/2012
marjorie, IN:

I am so lost I can`t find a nursing home that will accept my husband.I`ve tried everything, he is a dementia patient 69 years old but gets combative when he needs changed. It generally takes 3 to change him. He has smacked two patients but didn`t hurt them but everyone is afraid of him.He is in a geri pysh unit now but they say he has to leave, no more insurance.They say I will have to take him home that is not an option. Can they force me to pick him up? Please help,I am driving 1 1/2 hr one way now to see him. he has been in two nursing homes and they both sent him out. Thank You

Karen:

Dear M.,

Husband needs an updated diagnosis. Knowing which dementia husband is diagnosed with will help all decision-making. Dementia is a syndrome. Dementia presents specific symptoms and behaviors according to type. Confirming type and corresponding care need will help identify correct treatment plan to facilitate in the correct setting.

If you are his legal representative, you can proceed with scheduling a geriatric assessment with neurological component. This is easier to accomplish at the facility level otherwise you face transport and related involvement to accomplish the evaluation.

Facility should reevaluate husband every 90 days to reconfirm care arrangements and update treatment before moving a transfer forward. Transfer to hospital would instigate confirming diagnosis and need for followup. Without charity care in place, without insurance, the hospital is likely to discharge him as a patient.

Regarding your nursing home experiences, while Residency Agreement content will vary, generally a 30 day notice is across the board. Consider the timeframe they gave you and contact your local ombudsman who will launch an investigation to ensure rights were upheld.

Regarding securing a new nursing home placement, an updated diagnosis will be required. While some will admit any diagnosis to build census, it really is important staff skill meets case-mix need. The more open you can be with staff about husband’s behaviors and care needs, the better facility leadership can assess fit with level of care they provide. For financing issues, discuss options, including medicaid bed availability, with nursing home staff. These beds are never open for very long; most facilities have waiting lists. Recommend placing husband on a few wait lists so help is there for you when needed.

I urge you to obtain an updated diagnosis of husband so assistance can be appropriate to his need and met as soon as possible.